18 February 2021 – Mental Health Network – governance during the COVID-19 pandemic webinar

Overheard during the webinar:

[During a discussion about the NHS reform white paper]

“It is unnecessary to be told again that we have a duty to collaborate, and it risks organizing structures without having the clarity of form. The NHS constitution states that it belongs to the people, and they are the shareholders – where is the accountability to the people? There is no representation on the decision-making board for the population, which is concerning.”

“I worry about us trying to do everything all at once rather than taking small steps towards the goal of personalised care closer to home for everyone. It seems to make sense to try and get the NHS budget and house in order, with the goal of opening the door wider to involve the local authority.”

“The white paper feels like it was drafted before Covid, with no impetus to real integration, and only an ‘invitation’ to local authorities. The tension between place and provider collaboratives is evident and potentially inescapable.”

“We talk about ‘the’ local authority, when talking about purpose is it to improve population health or is to improve the integration of delivery of person centred care, and these conversations take you to different parts of the local authority. The economic development department might be the department if looking to improve mental health services. In mental health there is also collaboration with parts of the LA like housing associations, FE and employment advisers, whilst collaboration around place brings together different groups.”

“We are in danger of a rush to form rather than a proper understanding of function – and in putting that right we must ensure that better health is at the heart of the vision. It feels like an attempt to better manage an organisation – layers, decision making – with this approach leading us very rapidly to form but not function. I’m crying out for a vision of what healthcare will be like, which is easier to do locally than nationally, but the minute you do that you need to understand your locality and this takes you to public health, which can help develop a vision for better health. It feels like the white paper falls short of his own ambition for change.”

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